Interpret This Order For Me Please

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IV 1000ml D5 1/2 NS 60ml x 24 hours

I read it as D5W 1/2 NS at 60ml hour. Total volume to be given is 1000ml. However, 60 x 24 hours is 1440. So after 1000 was given I hung an extra bag to cover the 440ml

Y'all have provided just an additional reason I won't work inpatient (you're damned if you do, you're damned if you don't). Outpatient confusing orders are bad enough and they constantly need to be corrected. May of the MDs won't even enter them anymore. EPIC (or should I say the cash register) is an unwieldy monster. 

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Specializes in Peds.

I wasn’t the nurse who started the order. The IV fluid had already been running 9 hours prior to me arriving on shift.

On 1/21/2022 at 12:02 PM, sleepwalker said:

why not just hang the 1000mL bag and set it to run at 60mL/hr then clarify the order in the morning since you'd still be well under the total volume even 8-10hrs later? 

I didn’t write the order nor start the fluid. By the time I started my shift 9 hours had past already.

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Specializes in ICU.

Is this a computer generated order?  It looks alot like the ones I deal with, they always have the original container volume dose, then the given dose.  I'll try to remember to copy some down.  But Im with most; of the other posters; D5 half at 60 for 24 hours.  

 

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Specializes in ICU.
On 1/19/2022 at 4:38 AM, Runsoncoffee99 said:

Because the doctors  do not like us to call them at night unless an emergency. 
I got written up for calling a doctor about a fall that didn’t result in injury. 

I asked supervisor and she stated the 1000 meant the volume in the bag. That didn’t make sense to me either.

Written up for following (Im sure) standard hospital policy?  I wonder if you could bring this up to higher management and ask for clarification, what exactly does the policy state?

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Specializes in oncology.
On 1/24/2022 at 6:07 AM, Runsoncoffee99 said:

By the time I started my shift 9 hours had past already.

This is malpractice. 

On 1/24/2022 at 10:52 PM, Nursetom1963 said:

But Im with most; of the other posters; D5 half at 60 for 24 hours.  

 

I am thinking tha AM labs would show if this was productive (but NOT if it started 9 hours late.}  When did pharmacy send up the bag?

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2 hours ago, londonflo said:
On 1/24/2022 at 7:07 AM, Runsoncoffee99 said:

By the time I started my shift 9 hours had past already.

This is malpractice.

How so, exactly?

2 hours ago, londonflo said:

I am thinking tha AM labs would show if this was productive (but NOT if it started 9 hours late.}  When did pharmacy send up the bag?

I don't think the order was started late.  It reads as if the order was started 9 hours prior to @Runsoncoffee99 beginning her or his shift.

On 1/24/2022 at 7:07 AM, Runsoncoffee99 said:

[...]

I didn’t write the order nor start the fluid [emphasis added]. By the time I started my shift 9 hours had past already.

 

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Specializes in oncology.
5 hours ago, chare said:

By the time I started my shift 9 hours had past already.

I apologize, you are not at fault at all. I truly am sorry for what I said. 

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I assume this is a digital order. The IV fluid is probably selected from a list of 1000cc bags of different solutions and thus I don’t think the volume is key to this order. I would follow the directions and stop the infusion when the duration of 24 hours has been reached. 

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Specializes in Burn, ICU.

At my hospital I would call the pharmacy with this question, since (as others note) the 1000mL is probably the dispensed unit.  So if you're not familiar with how MAR orders are written at this facility (or if this one is wildly different from all other orders) I would confirm this with the pharmacy.  But I'd expect to do what you did: hang a bag, change the bag when empty, and then d/c the fluids after 24 hours at the end of the order.  (I mean, I probably wouldn't be at work for 24 hours straight to do all those things, but you know what I mean!)

At my hospital the provider prescribes the dose but the pharmacy specifies the dispensed units.  So the provider might prescribe 50mg metoprolol PO BID, and the pharmacy will decide that they are going to stock our Pyxis with 25mg tablets.  The MAR will say "2x25mg tablet" for each dose, but if I called the provider to ask them why the patient needs to get 2 25mg tablets instead of 1 50mg tablet, they would have no idea! 

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IV 1000ml D5 1/2 NS 60ml x 24 hours. This order is does not include the hourly rate. Clarification is required.

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On 1/19/2022 at 7:38 AM, Runsoncoffee99 said:

Because the doctors  do not like us to call them at night unless an emergency. 
I got written up for calling a doctor about a fall that didn’t result in injury. 

I asked supervisor and she stated the 1000 meant the volume in the bag. That didn’t make sense to me either.

 

So what?

Of course they don't like being called- who would?  So what?

They chose a particular job, and that job involves call?

I do all kinds of thing in my job I don't like.  Including trying to figure out poorly written orders.

 

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I read it as 60ml/h for 24 hours. However, this is not written properly. Personally Id look for another job.

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